Value of Index Beat in Evaluating Left Ventricular Systolic and Diastolic Function in Patients with Atrial Fibrillation: A Dual Pulsed-Wave Doppler Study

Abstract Atrial fibrillation (AF) poses challenges in use of the echocardiogram to assess left ventricular (LV) function. The index beat method has been found to agree well with the average method. We aimed to assess the value of the index beat method in evaluation of LV function using the dual pulsed wave Doppler technique. Peak early diastolic mitral inflow velocity (E) and diastolic (e′) and systolic (s′) mitral annulus velocity were simultaneously obtained and measured beat-to-beat in patients with AF. The index beat s′ exhibited the best correlation (r = 0.96 and 0.92, respectively, for septal and lateral wall, both p values = 0.000) with the mean, while E/e′ at the pre-index beat, rather than at the index beat-initiated cycle, had the best correlation with the mean (r = 0.88 for septal and 0.97 for lateral wall, both p values = 0.000).